Patients with a greater number of comorbidities and preoperative

Patients with a greater number of comorbidities and preoperative coronal

imbalance showed trends toward an increase in major failures, although these trends did not reach statistical significance. Age, sex, body mass index, smoking history, number of fusion segments, fusion grade, and several other radiographic values were not shown to be associated with an increased risk of major failure. Seventy Dorsomorphin percent of patients in the major failure group had anterior column support (anterior lumbar interbody fusion or transforaminal lumbar interbody fusion) while 80% of the nonfailure group had anterior column support.\n\nConclusions. The incidence of overall failure was 34.3%, and the incidence of clinically significant major failure of lumbopelvic fixation after long construct fusion for adult spinal deformity was 11.9%. Risk factors for major ERK inhibitor ic50 failures are a large pelvic incidence, revision surgery, and failure to restore lumbar lordosis and sagittal balance. Surgeons treating adult spinal deformity who use lumbopelvic

fixation should pay special attention to restoring optimal sagittal alignment to prevent lumbopelvic fixation failure.”
“Objectives: This article discusses how hard-to-reach population groups were 3 conceptualized into a search filter. The objectives of this article were to (1) discuss how the authors designed a multistranded population search filter and (2) retrospectively test the effectiveness of the search filter in capturing all relevant populations (eg, homeless people, immigrants, substance misusers) in a public health systematic review.\n\nStudy Design and Setting: Systematic and retrospective analysis via a case study. Retrospective analysis of the search filter was conducted by comparing the MEDLINE search

results retrieved without using the search filter against those retrieved with the search filter. A total of 5,465 additional results from the unfiltered AG-120 search were screened to the same criteria as the filtered search.\n\nResults: No additional populations were identified in the unfiltered sample. The search filter reduced the volume of MEDLINE hits to screen by 64%, with no impact on inclusion of populations.\n\nConclusions: The results demonstrate the effectiveness of the filter in capturing all relevant UK populations for the review. This suggests that well-planned search filters can be written.for reviews that analyze imprecisely defined population groups. This filter could be used in topic areas of associated comorbidities, for rapid clinical searches, or for investigating hard-to-reach populations. (C) 2014 Elsevier Inc. All rights reserved.”
“Although osteoinduction mechanism of calcium phosphate (CP) ceramics is still unclear, several essential properties have been reported, such as chemical composition, pore size and porosity, etc.

Serum IFN-b and IL-6 concentrations

in the infected contr

Serum IFN-b and IL-6 concentrations

in the infected control and MPYS(-/-) mice were also similar at 24 h postinfection, 432 suggesting that these pathogens stimulate MPYS-independent cytokine production during in vivo infection. Our findings indicate that bifurcating MPYS-dependent and – independent pathways mediate sensing of cytosolic bacterial infections. The Journal of Immunology, 2011, 187: 2595-2601.”
“Despite recent advances, there are still no interventions that have been developed for the specific treatment of young children who have anxiety disorders. This study examined the impact of a new, cognitive-behaviorally based parenting intervention on anxiety symptoms. Method: Families of 74 anxious children (aged 9 years or less) took part in a randomized controlled

trial, which compared the new 10-session, group-format intervention with a wait-list control condition. Outcome measures included blinded diagnostic interview and self-reports from parents and children. Results: Intention-to-treat analyses indicated that children whose parent(s) received the intervention were significantly less anxious at the end of the study than those in the control condition. Specifically, 57% of those Cl-amidine nmr receiving the new intervention were free of their primary disorder, compared with 15% in the control condition. Moreover, 32% of treated children were free of any anxiety diagnosis at the end of the treatment period, compared with 6% of those in the control group. Treatment gains were maintained at 12-month follow-up. Conclusions: This new parenting-based intervention may represent an advance in the treatment of this previously neglected group. Clinical trial registration information: Anxiety in Young Children: A Randomized Controlled Trial of a New Cognitive-Behaviourally Based Parenting Intervention; http://www.isrctn.orgi; ISRCTN12166762. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(3):242-251.”
“Purpose: The objective of the study was to determine if mouthwashes with a morphine-containing click here solution decrease oral pain associated

with radiotherapy- and/or chemotherapy-induced oral mucositis (OM).\n\nMethods: Randomized double-blinded crossover study to evaluate the effect of topical oral application of 2% morphine solution in patients suffering from radiotherapy- and/or chemotherapy-induced OM. Participants assigned to either the morphine solution or a placebo mouthwash received one of the solutions days 1-3 and were then switched over to the other treatment for days 4-6.\n\nResults: Nine patients were randomized in both groups. All patients (mean age, 55.1 +/- 3.0) except one had head and neck cancers. Mean intensity of pain associated with mucosal injury (World Health Organization [WHO] mucositis >= 2) was on a 10-point visual analogue scale: 6.0 +/- 2.7).

Mean ejection 3 fraction was 32% and re

Mean ejection fraction was 32% and resting heart rate was 71.6 bpm. Concomitant medications included beta-blockers (87%), renin-angiotensin system agents (89%), antithrombotic agents (94%), and lipid-lowering agents (76%). Conclusions:

Main results from BEAUTIFUL are expected in 2008, and should show whether ivabradine, on top of optimal medical treatment, reduces mortality and cardiovascular events in this population of high-risk patients. Copyright (c) 2007 S. 123 Karger AG, Basel.”
“Grainyhead transcription factors play an evolutionarily conserved role in regulating epidermal terminal differentiation. One such factor, the mammalian Grainyhead-like epithelial transactivator (Get1/Grhl3), is important for epidermal barrier formation. In addition to a role in barrier formation, Grainyhead genes play roles PCI-32765 order in closure of several structures such as the mouse neural S63845 tube and Drosophila wounds. Consistent with these observations, we found that Get1 knockout mice have an eye-open at birth phenotype. The failure of eyelid closure appears to be due to critical functions of Get1 in promoting F-actin polymerization, filopodia formation, and the cell shape changes that are required for migration of the keratinocytes at the leading edge during eyelid closure: The expression of TGF alpha, a known regulator of leading

edge formation, is decreased in the eyelid tip of Get1(-/-) mice. Levels of phospho-EGFR and phospho-ERK are also decreased at the leading edge tip. Furthermore, in an organ culture model, TGF alpha can increase levels of phospho-EGFR and promote cell shape changes as well as leading edge formation in Get1(-/-) eyelids, indicating that in eyelid closure Get1 acts upstream of TGFa in the EGFR/ERK pathway. (C) 2008 Elsevier Inc. All rights

“Among the great amount of genes presented in microarray gene expression data, only a small fraction is effective for performing a certain diagnostic test. In this regard, mutual information has been shown to be successful for selecting a set of relevant and nonredundant genes from microarray data. However, information theory offers many more measures such as the f-information measures that may be suitable for selection of genes from microarray gene expression data. This paper presents different f-information measures as the evaluation criteria for gene selection problem. To compute the gene-gene redundancy (respectively, gene-class relevance), these information measures calculate the divergence of the joint distribution of two genes’ expression values (respectively, the expression values of a gene-and the class labels of samples) from the joint distribution when two genes (respectively, the gene and class label) are considered to be completely independent.

These continuing

disparities suggest possible perception

These continuing

disparities suggest possible perception bias. More research is needed to confirm this disparity and explore the underpinnings.”
“BACKGROUND: Unplanned extubation represents a threat to patient safety, and risk factors and prevention strategies for unplanned extubation have not been fully explored. OBJECTIVES: To define high-risk patients for unplanned extubation and determine clinicians’ beliefs on perceived risks for unplanned extubation METHODS: With a Web-based survey instrument we surveyed critical care clinician members of the American Association for Respiratory Care, the American Association of Critical Autophagy Compound Library nmr Care Nurses, and the Society of Critical Care Medicine. RESULTS: Surveys were completed by 1,976 clinicians, including 419 respiratory therapists, 870 critical care nurses,

and 605 critical care physicians. The majority of respondents considered an outward migration of the endotracheal tube (by 3 cm, 2 cm if an air leak is present) to represent a risk for unplanned extubation. Respondents considered the following as high risk for unplanned extubation: absence of physical restraints (72% of respondents), a nurse/patient ratio of 1/3 (60%), trips out of the intensive care unit (59%), light sedation (43%), and bedside portable radiograph (29%). In addition, most respondents considered accidental removal of the nasogastric tube (71%) or tugging Compound Library research buy on the endotracheal tube (87%) by the patient to be risk factors for unplanned extubation. The Selleckchem Napabucasin rank order of the perceived risks was related to the respondents’ primary discipline. CONCLUSIONS: We identified perceived risk factors and defined “near misses” for unplanned extubation. Our findings should inform strategies for prevention of unplanned extubation.”

new mesoporous silicotitaniumphosphate material has been synthesized by using a non-conventional phosphorous source trimethyl phosphite with the aid of Pluronic F127 as structure directing agent (SDA). The mesopores are generated due to the slow hydrolysis of the reactant materials in the presence of supramolecular-assembly of non-ionic surfactant under the evaporation induced self-assembly (EISA) process. The material has been characterized by powder XRD, N-2 sorption, TEM, SEM-EDS, TG-DTA, FT-IR, XPS, Si-29, P-31 MAS NMR and UV-vis spectroscopic techniques. This new mesoporous material has considerably high BET surface area (379 m(2) g(-1)) and narrow pore size distribution with a peak pore width of 5.4 nm. The material showed good catalytic activity in the liquid phase Friedel-Crafts benzylation reaction suggesting strong acidity on its surface. It can also be used as good adsorbent for the removal of toxic metal ions As(III/V), Cd(II) and Hg(II) from the contaminated water. (C) 2010 Elsevier B.V. All rights reserved.

Methods Using a deterministic approach, we merged EMS data fr

\n\nMethods Using a deterministic approach, we merged EMS data from the North Carolina Pre-hospital Medical Information System (PreMIS) with data from the Reperfusion

Oligomycin A of Acute Myocardial Infarction in Carolina Emergency Departments-Emergency Response (RACE-ER) Project. Our sample included all patients with STEMI from June 2008 to October 2010 who arrived by EMS and who had primary percutaneous coronary intervention (PCI). Prehospital system delays were compared using both RACE-ER and PreMIS to examine agreement between the 2 data sources.\n\nResults Overall, 8,680 patients with STEMI in RACE-ER arrived at a PCI hospital by EMS; 21 RACE-ER hospitals and 178 corresponding EMS agencies across the state were represented. Of these, 6,010 (69%) patients were successfully linked with PreMIS. Linked and notlinked patients were similar. Overall, 2,696 patients were treated with PCI only and were taken directly to a PCI-capable hospital by EMS; 1,750 were transferred from a non-PCI facility. For those being transported directly to a PCI center, 53% reached the 90-minute target guideline goal. For those transferred from a non-PCI facility, 24% reached the 120-minute target goal for primary

PCI.\n\nConclusions We successfully linked prehospital EMS data with inhospital clinical data. With this linked STEMI cohort, less than half of patients reach goals set by guidelines. Such a data source could be used for future research ACY-738 cost and quality improvement P005091 in vitro interventions. (Am Heart J 2013;165:363-70.)”
“Binding of urokinase-type plasminogen activator (uPA) to its receptor, uPAR, in estrogen receptor-alpha (ER alpha) expressing breast cancer cells, transiently activates ERK downstream of FAK, Src family kinases, and H-Ras. Herein, we show that when uPAR is over-expressed, in two separate ER alpha-positive breast cancer cell lines, ERK 3 activation occurs autonomously of uPA and is sustained. Autonomous ERK activation

by OAR requires H-Ras and Rac1. A mutated form of uPAR, which does not bind vitronectin (uPAR-W32A), failed to induce autonomous ERK activation. Expression of human uPAR or mouse uPAR but not uPAR-W32A in MCF-7 cells provided a selection advantage when these cells were deprived of estrogen in cell culture for two weeks. Similarly, MCF-7 cells that express mouse uPAR formed xenografts in SOD mice that survived and increased in volume in the absence of estrogen supplementation, probably reflecting the pro-survival activity of phospho-ERK. Autonomous uPAR signaling to ERK was sensitive to the EGFR tyrosine kinase inhibitors, Erlotinib and Gefitinib. The transition in uPAR signaling from uPA-dependent and transient to autonomous and sustained is reminiscent of the transformation in ErbB2/HER2 signaling observed when this gene is amplified in breast cancer. uPAR over-expression may provide a pathway for escape of breast cancer cells from ER alpha-targeting therapeutics. (C) 2012 Elsevier Inc. All rights reserved.

There is much room for future improvement “
“In this study,

There is much room for future improvement.”
“In this study, apparent usability and affective quality were integrated in a design framework called the Usability Perception and Emotion Enhancement Model (UPEEM). The UPEEM was validated using structural equation modeling (SEM). The methodology consists of four phases namely product selection, attribute identification, design alternative generation, and design alternative evaluation.

The first stage involved the selection of a product that highly involves the consumer. In the attribute identification stage, design elements of the product were identified. The possible values of these elements were also determined for use in the experimentation process. Design of experiments was used to identify how the attributes will be varied in the design

alternative stage and which of the attributes selleck significantly contribute to affective quality, apparent usability, and desirability in the design evaluation stage. Results suggest that product attributes related to form are relevant in eliciting intense affect and perception of usability in mobile phones especially those directly related to functionality and aesthetics. This study considered only four product attributes among so many due to the constraints of the research design employed. Attributes related to aesthetic perception of a product enhance apparent usability such as those related to dimensional ratios. (C) 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.”
“We BTSA1 present an updated assessment of soil contamination due to the nuclear accident at the Fukushima No. 1 nuclear power plant on 11 March 2011. A safe limit for the spatial dose rate (micro-Sv/h) of gamma rays from Cs-134,Cs-137 has been established in this work. Based on this value, the highly contaminated region within Fukushima Prefecture that must be decontaminated could be defined. Moreover, SYN-117 a conceptual model for the

chemical speciation that occurred during the accident has been delineated. The compound model Cs2CO3 was found to be meaningful and practical (non-radioactive) to simulate contamination in our decontamination experiments. Finally, we explain the 4 mechanism of action of our soil remediation technique, which effectively reduces the total volume of contaminated soil by isolating the highly Cs-adsorptive clay fraction. The adsorption of non-radioactive Cs atoms on clay particles with diameters <25 mu m were analyzed using micro-particle-induced X-ray emission (PIXE). (C) 2013 Elsevier B.V. All rights reserved.”
“OBJECTIVE: To describe a technique to approach the anterior inferior basal ganglia.

In the batch mode, the biomass concentrations and lipid content o

In the batch mode, the biomass concentrations and lipid content of Chlorella sp. cultivated in a medium containing GSK2126458 0.025-0.200 g L(-1) urea were 0.464-2.027 g L(-1) and 0.661-0.326 g g(-1), respectively. The maximum lipid productivity of 0.124 g d(-1) L(-1) occurred in a medium containing 0.100 g L(-1) urea. In the fed-batch cultivation, the 3 highest lipid content was obtained by feeding 0.025

g L(-1) of urea during the stationary phase, but the lipid productivity was not significantly increased. However, a semi-continuous process was carried out by harvesting the culture and renewing urea at 0.025 g L(-1) each time when the cultivation achieved the early stationary phase. The maximum lipid productivity of 0.139 g d(-1) L(-1) in the semi-continuous culture was highest in comparison with those in the batch and fed-batch cultivations. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved.”
“The kinetic problem of a diffusion-mediated reaction, in which minority reactants are immobile and majority reactants are mobile, is known as the target problem. The standard theory of the target problem ignores the AZD8186 excluded volume interaction between the mobile reactants. Recently, a new theory of the target problem was proposed where the effect of excluded volume interaction was analytically investigated using a lattice model with prohibited double occupancy of the lattice sites. The results of that theory are approximate and need verification.

In this work, we perform Monte Carlo simulations on lattices and use their results to assess the accuracy of the analytical theory. We CRT0066101 purchase also generalize our theory to the case of different dimensionality and perform calculations for lattices in one-and two-dimensional systems. The analytical results accurately reproduce the simulation results except in the dilute limit in one dimension. For any dimensions, the decay of the target survival probability is accelerated by the presence of excluded volume interaction. (c) 2011 American Institute of Physics. [doi:10.1063/1.3560419]“
“Dual antiplatelet therapy with aspirin and a thienopyridine (ticlopidine or clopidogrel) has strikingly improved

the results of percutaneous coronary intervention (PCI) through a marked reduction in the rate of stent thrombosis (ST). Emerging data suggest that resistance to antiplatelet treatment may be a risk factor for ST. We report about a patient, aspirin and clopidogrel poor responder, who experienced 4 ST in 10 days. After the second ST, during antiplatelet therapy with aspirin (100 mg/die) and clopidogrel (75 mg/die), the patient’s platelet function was investigated with Platelet Function Analyzer 100, VerifyNow P2Y12 System and light transmission aggregometry (LTA). High platelet reactivity and combined resistance to aspirin and clopidogrel were found, and, as a consequence, treatment was switched to clopidogrel 150 mg and aspirin 300 mg/die. In spite of this adjustment, the third ST occurred.

The relationship between prion propagation, generation

The relationship between prion propagation, generation 3-Methyladenine clinical trial of neurotoxic species and clinical onset has remained obscure. Prion incubation periods in experimental animals are known to vary inversely with expression level of cellular prion

protein. Here we demonstrate that prion propagation in brain proceeds via two distinct phases: a clinically silent exponential phase not rate-limited by prion protein concentration which rapidly reaches a maximal prion titre, followed by a distinct switch to a plateau phase. The latter determines time to clinical onset in a manner inversely proportional to prion protein concentration. These findings demonstrate an uncoupling of infectivity and toxicity. We suggest that prions themselves are not neurotoxic but catalyse the formation of such species from PrPC. Production of neurotoxic species is triggered when prion propagation saturates, leading to a switch from autocatalytic production of infectivity (phase 1) to a toxic

(phase 2) pathway.”
“To determine the apicultural value of Vigna unguiculata (L.) Walp. (Fabaceae) beta-catenin inhibitor and evaluate the Apis mellifera adansonii Latreille (Hymenoptera: Apidae) activity on its pod and seed yields, the bee 123 foraging and pollinating activities were studied in Ngaoundere. The experiment was carried out within the University of Ngaoundere Campus on 210 flowers differentiated in two lots, based on the protection/or not of plant inflorescences against insect visits. The bee’s seasonal rhythm of activity, its foraging behaviour on flowers, the fructification rate, the number and dry weight of seeds/pod, the percentage of normal seeds/pod, and the pod length were evaluated. Results show that A. m. adansonii foraged on plants throughout the whole blooming period. Worker bees intensively and preferably harvested nectar. The greatest mean number of workers foraging simultaneously was 500 per 1000 flowers. The mean foraging speed was 8.67 flowers/min. These findings

allow the classification of V. unguiculata as a highly nectariferous bee plant. The number and dry weight of seed/pod, the pod length and the percentage of normal seeds/pod from unprotected SB525334 supplier flowers were significantly higher than those of flowers protected from insects. The fructification rates were 62 and 48%, while the percentages of healthly seeds were 97.61 and 76.17%, respectively in unprotected and protected inflorescences. The installation of A. m. adansonii colonies close to V. unguiculata field could be recommended to improve its pods and seeds production in the region.”
“The growing number of bacterial strains resistant to conventional antibiotics has become a serious medical problem in recent years. Marine sponges are a rich source of bioactive compounds, and many species can be useful for the development of new antimicrobial drugs. This study reports the in vitro screening of marine sponges in the search for novel substances against antibiotic-resistant bacteria.

Taken together, the results suggest that Translin contributes to

Taken together, the results suggest that Translin contributes to hematopoietic regeneration by acting as AL3818 a sensor protein for radiation-induced damage.”
“Objectives: Paraoxonase I (PON1) was known as a risk factor for cerebrovascular diseases. This study assessed the association of single nucleotide polymorphisms (SNPs) in the PON1 5′-regulatory region with ischemic stroke and serum PON1 activity.\n\nDesign and methods: Study subjects consisted of 418 healthy controls and 86

ischemic stroke patients with small vessel occlusion. SNPs were identified by DNA sequencing and a primer extension-based method.\n\nResults: Among 10 identified SNPs, only -1434GG genotype was observed with a lower frequency in patients on borderline statistical significance (OR(95% CI), 0.297(0.083-1.060), p=0.0615). However, haplotype analysis in a dominant model revealed that ht2 was observed with a significantly lower frequency in patients (OR(95%

CI), 0.390(0.153-0.991),p=0.0477). Both C(-1434)G mutation and ht2 distribution were associated with serum PON1 activity.\n\nConclusion: Our results suggest that haplotypes observed in the PON1 5′-regulatory region should be considered as risk factors for ischemic stroke. (C) 2009 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.”
“To explore the effect and mechanism of quercetin on proliferation and apoptosis of leukemia cells, and provide a theoretical basis for its clinical

GW786034 inhibitor application. HL-60 leukemia cell lines was treated with different dose quercetin, the proliferation activity of leukemia cells was assessed by MTT method; the morphological changes of apoptosis of HL-60 cells, including nuclear condensation and DNA fragmentation, 4-Hydroxytamoxifen datasheet were observed by Hoechst 33258 123 fluorescence staining, the apoptosis rate and caspase 2,3 activation were assessed by flow cytometry, and the cell signal pathway including phosphatidylinositol 3-kinase (PI3K), phosphorylated protein kinase B (pAkt), Bcl-2, Bax were detected by western blotting. Quercetin could significantly decrease the proliferation activity of HL-60 cells through the blockade of G(0)/G(1) phase, and induce the apoptosis of HL-60 cells in a time- and dose-dependent manner. Quercetin caused leukemia cells apoptosis by decreasing the protein expression of PI3K and Bax, the inhibitory phosphorylation of Akt, the decreased levels of Bcl-2 protein and increased activations of caspase-2 and -3, and increased poly(ADP-ribose) polymerase cleavage. Our results indicate that the apoptotic processes caused by quercetin are mediated by the decrease of pAkt and Bcl-2 levels, the increase of Bax level, and the activation of caspase families in HL-60 cells.”
“Eosinophilia is an established marker of asthma-related inflammation.

Herein, we will discuss current knowledge of the effects of antib

Herein, we will discuss current knowledge of the effects of antibodies and Fc gamma receptors on infant innate immunity to RSV. A better understanding of the pathogenesis of RSV infections in young infants may provide insight into novel therapeutic strategies such as vaccination. Copyright (c) 2013 John Wiley & Sons, Ltd.”
“Brain injury to the dorsal frontoparietal networks, including the posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (DLPFC), commonly cause spatial neglect. However, the interaction of these different regions in spatial attention is unclear.

The aim of the present study was to investigate whether hyperexcitable neural networks can cause an abnormal interhemispheric inhibition. CCI-779 purchase The Attention Network Test was used to test 123 subjects following intermittent theta burst stimulation (iTBS) to the left or right frontoparietal networks. During the Attention Network GSK3326595 in vitro Test task, all subjects tolerated each conditioning iTBS without any obvious iTBS-related side effects. Subjects receiving real-right-PPC iTBS showed significant enhancement in both alerting and orienting efficiency compared with those receiving either sham-right-PPC iTBS or real-left-PPC iTBS. Moreover, subjects

exposed to the real-right-DLPFC iTBS exhibited significant improvement in both alerting and executive control efficiency, compared with those exposed to either the sham-right-DLPFC or real-left-DLPFC conditioning. Interestingly, compared with subjects exposed to the sham-left-PPC stimuli, subjects exposed to the real-left-PPC iTBS had a significant deficit in the orienting Crenigacestat clinical trial index. The present study indicates that iTBS over the contralateral homologous cortex may induce the hypoactivity of the right PPC through interhemispheric competition in spatial orienting attention.”
“The mechanisms of transscleral iontophoresis have been investigated previously with small molecules

in rabbit sclera. The objective of the present study was to examine transscleral iontophoretic transport of charged macromolecules across excised human sclera. Passive and 2 mA iontophoretic transport experiments were conducted in side-by-side diffusion cells with human sclera. The effects of iontophoresis upon transscleral transport of model permeants bovine serum albumin (BSA) and polystyrene sulfonic acid (PSS) as well as a model drug bevacizumab (BEV) were determined. Passive and iontophoretic transport experiments of tetraethylammonium (TEA) and salicylic acid (SA) and passive transport experiments of the macromolecules served as the controls. The results of iontophoresis enhanced transport of TEA and SA across human sclera were consistent with those in a previous rabbit sclera study. For the iontophoretic transport of macromolecules BSA and BEV, higher iontophoretic fluxes were observed in anodal iontophoresis as compared to passive and cathodal iontophoresis.